ArticleNeuro-oncology practice2019
Acute neurologic toxicity of palliative radiotherapy for brain metastases in patients receiving immune checkpoint blockade.
Article in Neuro-oncology practice, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Safety of radiosurgery concurrent with systemic therapy (chemotherapy, targeted therapy, and/or immunotherapy) in brain metastases: a systematic review.Cancer metastasis reviews · 2021Pooled it
- The impact of current treatment modalities on the outcomes of patients with melanoma brain metastases: A systematic review.International journal of cancer · 2020Pooled it
- Immunotherapy for leptomeningeal disease from solid tumors: current clinical outcomes and future opportunities.Cancer metastasis reviews · 2024Review
- Optimal timing and sequence of combining stereotactic radiosurgery with immune checkpoint inhibitors in treating brain metastases: clinical evidence and mechanistic basis.Journal of translational medicine · 2023Review
- Acute toxicities and cumulative dose to the brain of repeated sessions of stereotactic radiotherapy (SRT) for brain metastases: a retrospective study of 184 patients.Radiation oncology (London, England) · 2023Article
- Radiotherapy combined with PD-1/PD-L1 inhibitors in NSCLC brain metastases treatment: The mechanisms, advances, opportunities, and challenges.Cancer medicine · 2023Review
- Integration of stereotactic radiosurgery or whole brain radiation therapy with immunotherapy for treatment of brain metastases.Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2020Article
- [Combination of Radiation Therapy and Immunotherapy for Non-small Cell Lung Cancer: Peer Exchange on Frontier Academic Topics].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2020Review
- Anlotinib Exerts Anti-Cancer Effects on KRAS-Mutated Lung Cancer Cell Through Suppressing the MEK/ERK Pathway.Cancer management and research · 2020Article
- Review
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe interaction between immune checkpoint blockade (ICB) and radiation (RT) for brain metastases has not been well understood. Given that acute neurotoxicity from this combination is not well characterized, we reviewed patients receiving ICB and RT for brain metastases.
methodsPatients treated with ICB and cranial RT from 2010 through 2017 were reviewed. ICB and RT must have been administered within 30 days of each other. Treatment parameters, performance status, symptoms prior to treatment, and toxicity were extracted from the electronic medical record. Survival was calculated from the end of RT to last follow-up or death.
resultsSeventy-eight patients were included. Median follow-up was 177 days (range, 12-1603). Median age was 64 years old (range, 29-98) and 47 (63%) were male. The main tumor types were melanoma (n = 47) and nonsmall-cell lung cancer (n = 19). Fifty-seven patients were treated with stereotactic radiosurgery (SRS) and 21 with whole-brain radiotherapy (WBRT). Most patients received single-agent ICB, though 4 patients received nivolumab and ipilimumab. Forty-one (53%) patients reported no neurologic toxicity. Grade 2 or greater neurologic toxicities were reported in 12 (21%) and 8 (38%) patients in the SRS and WBRT groups, respectively. WBRT was associated with a greater risk of any neurotoxicity, though there was no correlation between ICB agent and toxicity. Sequencing of ICB and RT (ie, <30 days vs <7) did not influence rates of toxicity.
conclusionsICB during SRS or WBRT does not appear to worsen acute neurotoxicity compared to historical controls of RT alone.
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